PubMed Health⌕ Search

Biomedical subjects

D Tuerlinckx

Publications and source records attributed to D Tuerlinckx.

At least 19 recordsLinked to original sources
PubMed2006

[Necrotizing pneumonia in children: apropos of 4 cases].

OBJECTIVES: To describe the necrotizing pneumonia in children, a severe affection which prevalence seems to increase; to review literature. PATIENTS AND METHODS: We report 4 cases of necrotizing pneumonia: symptoms, agents, diagnostic tools, treatment and long term evolution. RESULTS: In 2 cases, pneumatoceles could be seen at chest X-ray. Two patients presented a deficiency of anti-pneumococcal antibodies. Three needed insertion of a pleural chest tube of whom 1 had a resection of a small piece of necrotic lung. Duration of hospitalisation is longer than in uncomplicated pneumonias. CONCLUSION: Necrotizing pneumonia is a severe affection. Diagnosis has to be made by lung CT. Long term evolution is excellent in pediatric population with serious management at hospital.

Adolescent↗
PubMed2006

[Pleural effusion in childhood: management algorithm].

Based on an increased prevalence of empyema in children,we reviewed the literature on the diagnosis and management of this affection. A retrospective study of 11 children admitted to our hospital in 2003 shows a prolonged hospitalisation (median 18 days) even with adequate treatment. Based on our experience and data from the literature, we propose a management algorithm to allow treatment of children admitted ith pleural effusion.

Age Factors↗
PubMed2001

[Laryngitis revealing bacterial tracheitis in a five-year-old child].

CASE REPORT: We report the case of a five-year-old boy with clinical features of croup and left lower lobe pneumonia. Response to inhaled adrenaline and dexamethasone was incomplete and he developed respiratory distress. Direct laryngoscopy performed in the operating room showed mild glottic and subglottic inflammation. On bronchoscopy, there was thick pus coming from the left lower lobe. He was intubated for three days and regular toilet brought back thick pus. Tracheal fluid culture grew Haemophilius influenzae. COMMENTS: We suggest that he had bacterial tracheitis but that the tracheal involvement was not prominent at the time of diagnosis. CONCLUSION: Laryngoscopy and bronchoscopy in specialized surroundings should be considered for each child with croup unresponsive to conventional treatment, especially in case of lower respiratory tract involvement.

Administration, Inhalation↗
PubMed2001

Cutaneous lesions of disseminated cryptococcosis as the presenting manifestation of human immunodeficiency virus infection in a twenty-two-month-old child.

We report the case of a 22-month-old African boy with cutaneous lesions as the predominant feature of disseminated cryptococcosis (positive blood and cerebrospinal fluid cultures) and as the presenting manifestation of severe vertically acquired HIV infection (CDC C3 category). To our knowledge these cutaneous lesions have never been reported as the initial manifestation of AIDS in children.

AIDS-Related Opportunistic Infections↗
PubMed2001

[Lyme disease and facial paralysis in children].

Lyme disease is one of the most common cause of acute peripheral facial palsy in children. Overall nervous system involvement is also the predominant manifestation of Lyme disease in children, chiefly as facial palsy and/or aseptic meningitis. The medical records of ten patients with discharge diagnosis of facial palsy associated to borreliosis were retrospectively reviewed. The diagnostic criteria for borreliosis included acute peripheral facial palsy associated with erythema migrans (1/10) and/or positive Lyme serology in serum (10/10) or CSF (6/10). Facial palsy was associated with a high rate (9/10) of occult meningitis. Cerebrospinal fluid findings showed lymphocytic pleocytosis associated to moderate increased protein level. PCR assays displayed a very low sensitivity. All patients with meningitis were treated with intravenous ceftriaxone for 3 weeks and received their treatment as outpatients with an heparinised venous catheter. Our study confirm that borreliosis should be considered in every case of peripheral facial palsy and based on the high rate of occult meningitis, we also advocate to perform a lumbar puncture. Although long term prognosis of facial palsy associated with Lyme disease in children appears excellent, current treatment recommendations advocate prolonged antibiotic therapy.

Adolescent↗
PubMed1999

Limp as unusual presentation of Langerhans' cell histiocytosis.

UNLABELLED: An isolated eosinophilic granuloma involving the posterior elements of a lumbar vertebra is reported in a 3-year-old boy presenting with progressive limp. Radiological investigations revealed osteolysis of the L5 right pedicle. MRI showed a well-defined homogeneous mass with nonspecific signal intensity. An unusual feature was the paravertebral muscular location of the largest part of the tumour indicating a possible soft tissue origin. Immunohistochemical studies were typical for Langerhans' cell histiocytosis. CONCLUSION: A limp can be due to lumbar and paravertebral muscular location of Langerhans' cell histiocytosis.

Child, Preschool↗
PubMed1999

[Spontaneous pneumomediastinum in an adolescent: an underestimated cause of chest pain].

CASE REPORT: A case of mediastinal emphysema occurring without etiologic factor except a Valsalva's manoeuvre a few hours before admission in a 15-year-old boy is reported. Symptoms were cervical and chest pain with moderate dysphagia. Diagnosis was confirmed by palpating subcutaneous air in the neck region and mediastinal air on a chest roentgenogram. A CT scan was performed to exclude a concurrent pneumothorax. The patient recovered with bed rest. CONCLUSION: Spontaneous pneumomediastinum results from nontraumatic, mediastinal air leakage without underlying lung disease. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults; it is certainly underdiagnosed in this population.

Adolescent↗
PubMed1999

Foreign body aspiration in childhood: management algorithm.

Foreign body inhalation is still a major cause of morbidity and even mortality in the under-fives. To reduce its frequency, more severe preventative measures must be imposed and to allow for early diagnosis, a low threshold for bronchoscopy is necessary. This retrospective study is based on 33 children referred to us for suspicion of inhaled foreign body. Symptomatology, clinical and paraclinical data are reviewed. Based on our practice and on the experience gained from the literature, we propose a management algorithm which will need to be further assessed by a prospective study.

Algorithms↗
PubMed1999

[Urinary infection in the child: diagnosis, treatment, and prognosis].

Urinary tract infection is a common paediatric disease. Pyelonephritis may lead to severe renal damage (renal scarring), with possible arterial hypertension and renal insufficiency. Treatment and prognosis are closely related to a number of risk factors such as clinical, biological, radiological and scintigraphic data. The aim of the management is to give the most appropriate treatment and follow-up to avoid renal scarring.

Child↗
PubMed1999

Sweet's syndrome with arthritis in an 8-month-old boy.

Sweet's syndrome was diagnosed in a 4-month-old boy. He was successfully treated with systemic corticosteroids. At the age of 8 months, he developed acute arthritis in his right knee. The synovial fluid was analyzed and revealed a very high neutrophil count and neutrophil activation with a detectable level of intraarticular granulocyte-monocyte colony stimulating factor (GM-CSF). Prednisone injection into the knee led to dramatic improvement. No recurrence occurred. Although arthritis and/or arthralgia are common features in adult patients with Sweet's syndrome, this is the first reported case of Sweet's arthritis in a child.

Arthritis↗
PubMed1998

[Quality of the care of the pediatric patient admitted to the emergency room].

AIM: By a prospective study, authors tried to analyse the quality of management of the pediatric patient admitted in the emergency department. POPULATION AND METHODS: One hundred admission files were prospectively analysed for characteristics of age (mean age: 70 months), effectiveness of measurement of physiological parameters, evaluation of appropriateness of nursing management according to recorded parameters, length of stay in the emergency department according to the need for hospitalization, blood tests, X-rays and the seniority of the attending medical staff. RESULTS: Parameters were not, or only incompletely, recorded in 65 files. . Although all were recorded in the remaining 35 files, subsequent management was inadequate in seven cases. Mean length of stay in the emergency department was 116 minutes, influenced by the need for hospitalization (145 minutes compared to 102 minutes for the non-hospitalized children), timing of admission (mean: 125 minutes from 8 am to 6 pm, compared to 94 minutes from 6 pm to 8 am), need for blood tests, X-rays or both (mean: 122, 107 and 170 minutes respectively, compared to 55 minutes when no complementary exam was asked) and seniority of attending medical staff (mean: 65 minutes for permanent staff compared to 116 minutes for fellows). CONCLUSIONS: Measurement of physiological parameters must be standard practise in the management of pediatric patients admitted to the emergency department and must lead to appropriate management without undue delay. In order to reach this goal, emergency departments should be more adequately staffed with nurses and senior doctors specifically trained in the care of the pediatric patient. Blood tests and X-rays should be more readily available.

Age Factors↗
PubMed1997

Partial interferon-gamma receptor 1 deficiency in a child with tuberculoid bacillus Calmette-Guérin infection and a sibling with clinical tuberculosis.

Complete interferon-gamma receptor 1 (IFNgammaR1) deficiency has been identified previously as a cause of fatal bacillus Calmette-Guérin (BCG) infection with lepromatoid granulomas, and of disseminated nontuberculous mycobacterial (NTM) infection in children who had not been inoculated with BCG. We report here a kindred with partial IFNgammaR1 deficiency: one child afflicted by disseminated BCG infection with tuberculoid granulomas, and a sibling, who had not been inoculated previously with BCG, with clinical tuberculosis. Both responded to antimicrobials and are currently well without prophylactic therapy. Impaired response to IFN-gamma was documented in B cells by signal transducer and activator of transcription 1 nuclear translocation, in fibroblasts by cell surface HLA class II induction, and in monocytes by cell surface CD64 induction and TNF-alpha secretion. Whereas cells from healthy children responded to even low IFN-gamma concentrations (10 IU/ml), and cells from a child with complete IFNgammaR1 deficiency did not respond to even high IFN-gamma concentrations (10,000 IU/ml), cells from the two siblings did not respond to low or intermediate concentrations, yet responded to high IFN-gamma concentrations. A homozygous missense IFNgR1 mutation was identified, and its pathogenic role was ascertained by molecular complementation. Thus, whereas complete IFNgammaR1 deficiency in previously identified kindreds caused fatal lepromatoid BCG infection and disseminated NTM infection, partial IFNgammaR1 deficiency in this kindred caused curable tuberculoid BCG infection and clinical tuberculosis.

Adolescent↗
PubMed1997

Disseminated Mycobacterium avium infection in a child with decreased tumour necrosis factor production.

UNLABELLED: Disseminated atypical mycobacterium infection is essentially reported in cellular immunodeficient children. Cell-mediated immunity including cytokines like tumour necrosis factor alpha (TNF) and gamma interferon (IFN) is the most important factor allowing control of the dissemination of Mycobacterium. We report a child with disseminated Mycobacterium avium infection without classical immunodeficiency or HIV infection. Immunological studies revealed a defect of TNF production when the monocytes of the patient were primed with endotoxin (Escherichia coli). CONCLUSION: This patient represents a further case of possible macrophage defect explaining the susceptibility to intracellular pathogens.

Child, Preschool↗
PubMed1997

Unifocal cervical Castleman disease in two children.

UNLABELLED: Castleman disease (CD) is a benign lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes. Most observations focus on adult patients. In children the disease is rare, usually localized and may be symptomatic or asymptomatic. We reported two children, 7 and 14 years old respectively, affected by unifocal cervical CD of the hyaline vascular type. CONCLUSION: Two cases illustrate that CD may mimic a neoplasm and should be considered in presence of a solitary neck mass with specific features on CT and MRI.

Adolescent↗
PubMed1997

Very long chain acyl-coenzyme A dehydrogenase deficiency in two siblings: evolution after prenatal diagnosis and prompt management.

A boy had neonatal seizure, lethargy, and metabolic acidosis at presentation. He recovered completely, but the recurrence of a similar episode with associated cardiomyopathy and dicarboxylic aciduria at 10 months of age led to the recognition of a fatty acid oxidation defect. A diagnosis of very long chain acyl-coenzyme A dehydrogenase deficiency was later made by enzyme assay in culture fibroblasts from this child, as well as in cultured amniotic cells from a sibling fetus. This prenatal diagnosis forestalled neonatal injury by close clinical and metabolic monitoring of the second infant. Early diagnosis and management should potentially improve the generally poor prognosis for patients with very long chain acyl-coenzyme A dehydrogenase deficiency.

Acidosis↗